From the Overview to the Patient: How To Interpret Meta-analysis Data

  • R. D. Gelber
  • A. Goldhirsch
Conference paper
Part of the Recent Results in Cancer Research book series (RECENTCANCER, volume 127)


Clinical investigators have not easily accepted the concept of meta-analysis. Those who perform these formal statistical combinations of data from several different trials have been referred to as “those burgeoning band of interlopers, the meta-analysts” [1]. Critics have referred to meta-analysis as “pooling, drowning, and floating” in the past [2], and even today many view the exercise as potentially dangerous, and clearly a threat to the integrity and importance of the individual clinical trial [3, 4].


Estrogen Tamoxifen 


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Horton R (1991) Conference report: double dealing with your data. Lancet 337:784–785CrossRefGoogle Scholar
  2. 2.
    Goldman L, Feinstein AR (1979) Anticoagulants and myocardial infarction: the problems of pooling, drowning, and floating. Ann Intern Med 90:92–94PubMedGoogle Scholar
  3. 3.
    Wachter K (1988) Disturbed by meta-analysis? Science 241:1407–1408PubMedCrossRefGoogle Scholar
  4. 4.
    Mann C (1990) Meta-analysis in the breech. Science 249:476–480PubMedCrossRefGoogle Scholar
  5. 5.
    Early Breast Cancer Trialists’ Collaborative Group (1988) Effects of adjuvant tamoxifen and of cytotoxic therapy on mortality in early breast cancer: an overview of 61 randomized trials among 28896 women. N Engl J Med 319:1681–1692CrossRefGoogle Scholar
  6. 6.
    Gelber RD, Goldhirsch A (1986) The concept of an overview of cancer clinical trials with special emphasis on early breast cancer. J Clin Oncol 4:1696–1703PubMedGoogle Scholar
  7. 7.
    Gelber RD, Goldhirsch A (1987) The evaluation of subsets in meta-analysis. Stat Med 6:371–388PubMedCrossRefGoogle Scholar
  8. 8.
    Early Breast Cancer Trialists’ Collaborative Group (1992) Systemic treatment of early breast cancer by hormonal, cytotoxic or immune therapy: 133 randomised trials involving 31000 recurrences and 24000 deaths among 75000 women. Lancet 339:1–15, 71–85Google Scholar
  9. 9.
    Gelber RD, Goldhirsch A, for the International Breast Cancer Study Group (formerly Ludwig Group) (1992) Reporting and interpreting adjuvant therapy clinical trials. J Natl Cancer Inst Monogr 11:175–180Google Scholar
  10. 10.
    Altman LK (1992) Study on breast cancer finds therapy is effective for years. New York Times, Jan 4Google Scholar

Copyright information

© Springer-Verlag Berlin · Heidelberg 1993

Authors and Affiliations

  • R. D. Gelber
    • 1
  • A. Goldhirsch
    • 2
  1. 1.Harvard Medical School, Harvard School of Public HealthDana-Farber Cancer InstituteBostonUSA
  2. 2.International Breast Cancer Study GroupOspedale CivicoLuganoSwitzerland

Personalised recommendations